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EM@3AM: Brugada Syndrome

EMDocs

A 36-year-old female presents to the ED after experiencing an episode of sudden syncope. Patients with Brugada syndrome should have a prompt cardiology consultation for consideration of implantable defibrillator placement due to the high risk of sudden cardiac death. 2012 May;9(5):752-9. Heart Rhythm. Heart Rhythm.

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What is strange about this paroxysmal atrial fibrillation in an otherwise healthy patient? And what happened after giving ibutilide?

Dr. Smith's ECG Blog

We examined the effect of ibutilide, a class III antiarrhythmic agent, on the energy requirement for atrial defibrillation and assessed the value of this agent in facilitating cardioversion in patients with atrial fibrillation that is resistant to conventional transthoracic cardioversion. Methods. . =

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A Middle-Aged male with Chest Pain and an Unusual ECG

Dr. Smith's ECG Blog

Only 5-18% of ED patients with chest pain have a myocardial infarction of any kind. Cardioversion/defibrillation. Electrocardiol 45:433-442, 2012 ). Could this be a coincidence that the patient was experiencing chest pain and upon ECG capture the atypical brugada pattern was found? It helps a little bit. Only 1-5% have OMI.

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Cardiac Rhythms/ECG Module

Don't Forget the Bubbles

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

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A young F is hyperthermic, delirious, and dry: Fever-induced Brugada? Diphenhydramine toxicity? Tricyclic?

Dr. Smith's ECG Blog

J Electrocardiology 45 (2012):433-442. If there are any syncopal or presyncopal events, she should be evaluated immediately in the ED. --All Implantable Cardioverter-Defibrillator ), with long-term potential for device-related complications from the ICD, including inappropriate shocks? Bayes de Luna, A et al.

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

1999). -- Comment by K EN G RAUER, MD ( 1/30/2019 ): -- Superb presentation and discussion by Dr. Alexandra Schick ( with edits by Dr. Smith ) of an elderly woman who was seen in the ED for altered mental status, hyperthermia, and the initial ECG shown above. Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias.

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